Eating out is associated with higher caloric, fat and sugar intake in a Type 2 Diabetic population: The Diabetes Study of Northern California (DISTANCE)

BACKGROUND: Conscientious dietary intake is an important component of chronic disease management, especially in Type 2 Diabetes (T2DM). This study examines the association of the frequency of eating out and diet quality in a T2DM population. Foods eaten away from home account for nearly half of total food expenditures in the U.S. Large portion sizes, higher energy densities and lack of healthy options are common in restaurants, vending machines and other locations, negatively impacting diet quality and health. METHODS: 474 Kaiser Permanente health plan members (F=55%, M=45%) participating in the Diabetes Study of Northern California (DISTANCE), completed two 24-hour diet recalls. We queried about the average number of meals eaten out per week. Linear regression models were used to compare those reporting eating out ≤1 times/week versus ≥3 times/week. RESULTS: Adjusting for income and gender, the higher frequency of eating out was associated with greater caloric intake (β=191.7kcal, p < 0.016), higher percentage calories from fat (β=2.5%, p<0.015) and saturated fat (β = 0.98%, p<0.035), greater consumption of trans fat (β=0.83g, p<0.002) and added sugars (β=8.6g, p < 0.06); lower consumption of fiber (β=-2.3g, p<0.041), and fewer servings of fruit (β=-0.43, p<0.019). DISCUSSION: Healthier selections and smaller portions should be promoted in foods offered outside of the home. Patients with T2DM should also be encouraged to reduce the frequency of eating outside of the home and, when they do, a more careful meal selection should be considered as new recommendations for diet management in this chronic disease.